HESI RN Exit Exam Test Bank
2025/2026 (Versions 1–7) + BONUS
Past Papers 2022–2024 with
Diagrams, Rationales & Pictures
,TABLE OF CONTENTS
HESI RN Exit Exam v1 ...................................................................................... 3
HESI RN Exit Exam v2 .................................................................................. 149
HESI RN Exit V3 ........................................................................................... 204
HESI Exit RN V4............................................................................................ 261
HESI Exit RN V5 ........................................................................................... 304
HESI Exit RN V6 ........................................................................................... 349
HESI EXIT RN V7.......................................................................................... 391
ADDITIONAL HESI EXIT RN EXAM V1-V7 PAST PAPER FROM 2022-2024 WITH
PICTURES,RATIONALES AND DIAGRAMS ....................................................... 528
HESI EXIT EXAMS V1 – V7
,HESI RN Exit Exam v1
The nurse is completing the admission assessment of a 3-year-old who is
admitted with bacterial meningitis and hydrocephalus. Which
assessment finding is evidence that the child is experiencing increased
intracranial pressure (ICP)?
A. Tachycardia and tachypnea
B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope
- ✔✔- ANSWER-✔✔-
B. Sluggish and unequal pupillary
responses
Rationale:
Sluggish and unequal pupillary responses are a direct sign of increased
intracranial pressure affecting cranial nerves, particularly the
oculomotor nerve (cranial nerve III). These findings indicate neurologic
deterioration and warrant immediate intervention.
Explanation of Incorrect Options:
A. Tachycardia and tachypnea: These are nonspecific findings and
may occur with fever or infection but are not reliable
indicators of increased ICP. In fact, bradycardia (not tachycardia) is
often seen with rising ICP.
C. Increased head circumference and bulging fontanels: These are
signs more typically seen in infants due to open sutures. By 3 years
of age, the fontanels are generally closed, making this less likely.
D. Blood pressure fluctuations and syncope: While late signs of
increased ICP can include changes in vital signs, syncope is not
typically associated with elevated ICP in children and is more
common with cardiac or vasovagal events.
, Test-Taking Tip:
In pediatric patients, neurologic signs like pupillary changes and
altered level of consciousness are more reliable indicators of increased ICP
than general signs such as changes in heart rate or respiratory rate. Know
which signs are age-appropriate.
DIF: Analysis
REF: Pediatric Nursing: Content Review and NCLEX®-Style Q&A OBJ:
Neurological assessment and prioritization in pediatrics TOP: Pediatric
Neurological Disorders
A client with acute pancreatitis is admitted with severe, piercing abdominal
pain and an elevated serum amylase. Which additional information is the
client most likely to report to the nurse?
A. Abdominal pain decreases when lying supine
B. Pain lasts an hour and leaves the abdomen tender
C. Right upper quadrant pain refers to right scapula
D. Drinks alcohol until intoxicated at least twice weekly.
- ✔✔- ANSWER-✔✔-A. Abdominal pain decreases when lying supine
Rationale:
Chronic or binge alcohol consumption is one of the most common
causes of acute pancreatitis. Alcohol leads to inflammation of the
pancreatic ducts and premature activation of pancreatic enzymes,
which results in autodigestion of the pancreas and intense abdominal pain.
Explanation of Incorrect Options:
A. Abdominal pain decreases when lying supine: This is incorrect.
Pancreatic pain typically worsens when lying flat and improves when
sitting up and leaning forward.
B. Pain lasts an hour and leaves the abdomen tender: Pancreatic pain
is persistent and severe, often lasting for hours to days. It is not
typically transient.
2025/2026 (Versions 1–7) + BONUS
Past Papers 2022–2024 with
Diagrams, Rationales & Pictures
,TABLE OF CONTENTS
HESI RN Exit Exam v1 ...................................................................................... 3
HESI RN Exit Exam v2 .................................................................................. 149
HESI RN Exit V3 ........................................................................................... 204
HESI Exit RN V4............................................................................................ 261
HESI Exit RN V5 ........................................................................................... 304
HESI Exit RN V6 ........................................................................................... 349
HESI EXIT RN V7.......................................................................................... 391
ADDITIONAL HESI EXIT RN EXAM V1-V7 PAST PAPER FROM 2022-2024 WITH
PICTURES,RATIONALES AND DIAGRAMS ....................................................... 528
HESI EXIT EXAMS V1 – V7
,HESI RN Exit Exam v1
The nurse is completing the admission assessment of a 3-year-old who is
admitted with bacterial meningitis and hydrocephalus. Which
assessment finding is evidence that the child is experiencing increased
intracranial pressure (ICP)?
A. Tachycardia and tachypnea
B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope
- ✔✔- ANSWER-✔✔-
B. Sluggish and unequal pupillary
responses
Rationale:
Sluggish and unequal pupillary responses are a direct sign of increased
intracranial pressure affecting cranial nerves, particularly the
oculomotor nerve (cranial nerve III). These findings indicate neurologic
deterioration and warrant immediate intervention.
Explanation of Incorrect Options:
A. Tachycardia and tachypnea: These are nonspecific findings and
may occur with fever or infection but are not reliable
indicators of increased ICP. In fact, bradycardia (not tachycardia) is
often seen with rising ICP.
C. Increased head circumference and bulging fontanels: These are
signs more typically seen in infants due to open sutures. By 3 years
of age, the fontanels are generally closed, making this less likely.
D. Blood pressure fluctuations and syncope: While late signs of
increased ICP can include changes in vital signs, syncope is not
typically associated with elevated ICP in children and is more
common with cardiac or vasovagal events.
, Test-Taking Tip:
In pediatric patients, neurologic signs like pupillary changes and
altered level of consciousness are more reliable indicators of increased ICP
than general signs such as changes in heart rate or respiratory rate. Know
which signs are age-appropriate.
DIF: Analysis
REF: Pediatric Nursing: Content Review and NCLEX®-Style Q&A OBJ:
Neurological assessment and prioritization in pediatrics TOP: Pediatric
Neurological Disorders
A client with acute pancreatitis is admitted with severe, piercing abdominal
pain and an elevated serum amylase. Which additional information is the
client most likely to report to the nurse?
A. Abdominal pain decreases when lying supine
B. Pain lasts an hour and leaves the abdomen tender
C. Right upper quadrant pain refers to right scapula
D. Drinks alcohol until intoxicated at least twice weekly.
- ✔✔- ANSWER-✔✔-A. Abdominal pain decreases when lying supine
Rationale:
Chronic or binge alcohol consumption is one of the most common
causes of acute pancreatitis. Alcohol leads to inflammation of the
pancreatic ducts and premature activation of pancreatic enzymes,
which results in autodigestion of the pancreas and intense abdominal pain.
Explanation of Incorrect Options:
A. Abdominal pain decreases when lying supine: This is incorrect.
Pancreatic pain typically worsens when lying flat and improves when
sitting up and leaning forward.
B. Pain lasts an hour and leaves the abdomen tender: Pancreatic pain
is persistent and severe, often lasting for hours to days. It is not
typically transient.
